Human blood sample tests positive for Ebola Reston Virus infection

Health Secretary Duque explains the body's response to the Ebola Reston Virus

Health Secretary Duque explains the body's response to the Ebola Reston Virus

“Today, Secretary Duque III announced that a human blood sample tested positive for ERV IgG antibodies. This means that the person was exposed to ERV more than six months ago and did not get sick. Clinical examination showed that the positive human case remains apparently healthy and claimed no serious illness in the past 12 months.” – DOH press release. Notes taken during presscon inside. Caveat: there are many errors, grammatical and otherwise. Sorry, don’t have time to edit and correct.

Authorities Friday announced a human blood sample tested positive for antibodies to the Ebola Reston Virus, which meant the person was infected.

However, the antibodies found were old, indicating an infection at least six months ago. The subject, health officials said, remains healthy and has not reported any illness in the last six months.

Health officials refused to give more details about the infected person, saying they needed to find out first how the infection was acquired and when. The confirmation that a human blood sample was positive for ERV (Ebola Reston Virus) was made only Friday morning by the US Centers for Disease Control. The Philippine government had sent 50 human blood samples for testing.

The blood samples were collected after four pigs were found positive for ERV in the provinces of Bulacan and Pangasinan. The two farms from which the pigs came are now in quarantine. The Philippine government has also maintained a self-imposed ban on exports of pig products.

The strain of Ebola Reston Virus found in Philippine monkeys is endemic to the Philippines. Last year, however, a similar strain was found in pigs, prompting a group of international experts to come here to help the government investigate.

In the past, 25 people were infected with the virus’ strain found in monkeys. This is the first time that the virus was found outside of primates, and the international experts wanted to find out how the pigs were infected with the virus, and how the virus will affect the pigs. Since pigs are livestock, they are more often handled by humans than monkeys are.

note on press conference:
Duque: on jan 5 2009 the joint…who mission started work in our country to assess animal and human health risk of ebola reston virus or erv. Joint fao-oiv together with local counterparts sent teams to 2 quarantine farms in bulacan and pangasinan. Quarantine imposed by da following confirmation by erv from tissues samples…tasked to determine most likely source of erv…investigated risks that predisposed pigs to human transmission and potential implications related to food safety. Also current lab capacity in country…more lab expeirments are needed to determine exactly how erv affects pigs and if pig to pig transmission occurs.

Update: the ritm has reported that the partial results of pig blood samples collected by joint mission from apparently healthy pigs negative for erv antigens. Results of tests by us centers for disease control and prevention on tissue samples available next week. Needed to determine whether still ongoing ebola transmission…on pigs on these farms. Until results available, both farms under quarantine. Phil gov’t continue with voluntary export ban on pigs and frozen pig products.

Blood samples of people on farms and who may have been exposed also tested to determine possible risk to human health. In past…did not get sick except for one who manifested mild flu like symptoms…highest risk with blood and other body fluids.

Human blood sample tested positive for antibodies against ebola virus. This morning received confirmation likely an old infection based on negative results from ign anti bodies. Ign antibodies indicate recent infection. Us cdc revealed no ign antibodies. Simply mean this was an old infection. This new finding in human still presents a negligible risk to human health. Positive igg test means person exposed to reston virus more than six months ago and not likely shedding virus. Clinical exam show no findings, apparently healthy and claims no serious illness in past 12 months. Since person not get sick chances of exposing others extremely unlikely. Investigations now being undertaken on how person exposed to reston virus. About 50 possibly exposed individuals in two quarantine commercial farms who were examined, interviewed, or tested. Tests still ongoing and no..for antibodies…

Yap and I already organized erv management team for members from both our agencies to learn more about newly discovered infection…sec yap ordered widening scope of testing for erv covering not only swine infection in Luzon both other farms where there are reports of abnormal death or sickness…asking all lgus and public to report any occurrence of unusual pig illness or deaths through erv management team hotline.

The ritm started efforts to improve capacity and enhance diagnostic efficiency in determining erv and other…cdc and Japanese laboratory experts from national infectious disease in Tokyo…pork from healthy pigs is safe to eat so long as properly handled and thoroughly cooked. Tighten monitoring of double dead meat to protect public…continue to work with national and international counterparts…regular updates regarding ongoing investigation shall be provided as new developments unfold.

(what happens to…infected? Hospital, etc) tayag: the person with human blood sample has been investigated, still awaiting further results of investigation, not give identity and possible exposures are also being investigated, give all information needed as we proceed with our investigation.

(worker in which farm) duque: asking if person…

Catbagan:

Tayag: at this time we cannot reveal any other details except investigation is ongoing. All information revealed in proper forum so we will know how this person who had positive result was exposed. We will give report of investigation team as soon as possible. At this time we cannot reveal identity including gender. The person is apparently healthy, we did clinical exam, in the past 12 months he had not reported any form of illness, remains healthy at this time.

(he got infection months before, from pigs) the results show it’s a past infection but we cannot at this time link it to pigs. The investigation is still ongoing, study link of infection, includes pig to human infection.

(antibodies of erv detected) duque: virus was not detected in the person. Antibodies of igg type by ritm and subsequently by us cdc. Igg positive, igm negative by us cdc.

Ritm tested a blood sample of the person and yielded igg positive, which only means, that this means an old exposure, an old infection, probably six months or longer. The igm will tell you if this a recent infection and because us cdc had given out the result that this is igm negative can safely assume wala syang recent infection.

Igm and igg are antibodies which the human body generates in response to an antigen. The antigen could be a virus, bacteria, parasite, something which the body reacts to. Defense mechanism of body against invading pathogens and the pathogens fall within what is known as antigens.

(igg that was found positive specific reactor to erv? Or another pathogen) it is specific because the test uses the antibodies specific for erv or any of its properties.

(what who thinks of significance of finding) hult: think this demonstrates there has been close cooperation during mission. Able to test range of humans to see if indeed any of them do have antibodies against erv virus. In past, know 25 humans had very close contact with sick monkeys, generated antibodies in response to exposure or close contact with those sick monkeys. Not surprising we found human who has generated antibody against virus. Whole detail of how exposure occurred…under investigation…I don’t think that we can say more at this point in time about this particular incident. Under investigation…testing ongoing in number of humans exposed to virus to get fuller understanding of what virus could do if people are exposed to it. 26 individuals in world who have developed antibodies to this virus, not suffered significant illness…

Catbagan: how many pigs were found positive, only those pigs that were sent to cdc in july, aug, sept, four pigs. From time diagnosed as such from present. Since oct to present no sign. In manaoag, 1,200 and in pandi bulacan we have 4,600 pigs.

We don’t even know which infected pigs.

Lebroth: (how can we explain pigs getting erv) that particular question perplexes us as well in international community. First time virus seen in livestock, food producing animal.

Hult: three associated with high mortality but ebola reston is strain only found in phils but in monkeys. That strain we know can be transmitted to humans following very close contact with sick animals but 25 individuals worldwide…which indicates virus entered bodies and mounted response to that, but those 25 individuals none suffered from serious illness. Ebola different from African strain but fall within same family. Not caused serious illness, one tested positive for those antibodies, indicating infection at least six months old. Maybe the ebola reston virus are really quite different and cannot cause significant illness in humans but because first finding in pigs, in close contact with humans, important to understand issue further.

(matter of potential concern) hult: as we said previously it is not a surprise finding, know that this is a virus that…can transmit from animal to human, animal very sick, human in very close contact with that animal, that’s when virus can transmit. Not surprised when found in pigs, that we have an individual…it’s a finding that requires further exploration and more investigation. Those investigations are ongoing so we can establish situation more clearly…

(first time transmission pigs to humans, more worrisome than from monkeys to humans) tayag: not complete yet, still trying to establish exposure and the link. Hult: reiterate. We have not yet conclusively confirmed that link, hope info will become more available over a course of time.

Tayag: all exposure links are being investigated, including animals such as monkeys. Not yet complete. Ask media not to speculate on possible exposure.

Pig to human trasnmission, pig to pig transmission, not yet established. Exposure link of person who tested positive…

Yap: we are not telling people not to consume pork.

(antibodies is six months old, what is significance to exposure links) hult: following on from what duque had explained about antibodies, when virus enters body, produce killer cells to fight it off…first type of cells produces are idm…immediate response cells, with erv we think those antibodies are produced 2 weeks after infection, go away after 5 months, become undetectable, longer memory cells who can fight infection if there is again. Appear one month after infection, last 18 mos to 2 years, not sure how long they last. Individual negative for those immediate antibodies, not exposed to viruses, not entered body, within last six months. Older memory cells indicate infection occurred 6-18mos ago…person has been exposed to virus, body recognized, produced killer fighter cells but not infection that has occurred in last six months.

Cleared virus, highly unlikely (that virus is still there). Incubation, 3-7 days, develop fever, but no strong evidence of illness for reston virus. Yellow line, represents viran antigen. Virus goes down to undetected levels. At about bet 3-15 days, igm goes down over time, may stay up to 6mos at most.

Tayag: Incubation period 2-21 days. He was not sick, when he got exposed, the antibodies were produced. We have to look at exposure from 6-18mos, why taking us sometime to explain or describe exposure because we have to look back 6-18mos. What happened during that time? Cannot give definitive or conclusive link…

Duque: the antibodies are meant to defend the person from invading pathogens. Good that we see these antibodies, meant to neutralize the virus. (25 infected by monkeys, how long exposed and can be considered safe) 1989, 1990, 1992, 1996 events. Of the six that tested positive, purportedly infection from phil macaque monkeys to handlers, only one manifested very mild flu like symptoms. Eventually recovered.

Tayag: persons included investigation not under quarantine. Only two farms and pigs are in quarantine, not the persons.

Catbayag: looked into (likelihood of virus in other farms)

(new steps because of new findings) yap: explain, inform that doing wider surveillance of farms, accelerating blood testing of samples of all hogs on our database…stricter border control between provinces, national meat inspection service alerted to put up inspection points…monitoring of slaughterhouses, retail stores in our public markets. This would suffice at this point (okay with who)

(unique in ebola or general behavior of viruses) generally how human body reacts to most antigens and pathogens.

(because we are waiting for results of at least 50 possible exposed persons or humans, person with positive result tested earlier) collected blood samples from possibly exposed humans, even before mission started. Still collecting new samples because we want to make sure all those possible exposed will be tested and results given as soon as we have these results. In the next few days, as soon as we get results we will share…sec of health only reported one positive sample from a person. All in all including old samples, belong to 50 exposed persons. In the investigation there were occasions that we had to get more than one blood sample so cannot give how many samples and how many positive or negative. 50 individuals with possible exposure, one positive. Possible exposed, farm and slaughterhouse.

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